The first symptoms of duodenal cancer. Survival in duodenal cancer Secondary tumor in the duodenum

Duodenal cancer is a malignant tumor located in the beginning of the small intestine. This pathology is rarely diagnosed at a young age. It most often affects men and women over 50 years of age.

The intestine begins with the duodenum 12 and the risk factors for its oncology include:

• chronic inflammation of the gastrointestinal tract - Crohn's disease;
• diffuse, inherited. These are small tumor-like growths of cells in the form of polyps of different shapes and sizes that protrude into the intestinal lumen;
• benign vilene soft in the form of cauliflower, reaching large sizes;
• heredity: in the presence of oncological tumors in relatives;
• abuse of spicy, salty and smoked foods, coffee, meat, animal fats and bad habits: alcohol and smoking;
• irrational nutrition with a lack of vegetable and fruit products;
• diabetes mellitus, chronic pancreatitis, cholelithiasis.

Precancerous diseases of the duodenum

There are conflicting opinions among physicians about peptic ulcer of the duodenum, as its precancerous condition. Patients complain of pain in the upper abdomen with a return to the hypochondrium on the right and left, in the region of the lumbar and thoracic spine, shoulder blade and chest on the left. The pains are accompanied by heartburn, nausea and vomiting, sour belching and a tendency to constipation. In terms of symptoms, duodenal cancer looks like an ulcer, so it is difficult to distinguish between these diseases.

Doctors believe that in order for an ulcer to degenerate into, appropriate conditions are necessary, such as long-term relapses of the disease in the absence of adequate therapy, a genetic predisposition. It is believed that an ulcer gives rise to cancer, but it can also occur against its background. A possible reason for the degeneration of an ulcer into cancer may be a disturbed process of reproduction and growth of cells (growing up) in the focus of inflammation of a chronic ulcer.

If bowel cancer, in particular duodenal cancer, is suspected, it is important to identify in patients not only precancerous diseases, but also precancerous changes in the digestive organs as a whole.

For example, it is worth worrying in the presence of chronic diseases with metaplasia and dysplasia:

• esophagitis;
• gastritis;
• colitis.

Therefore, a histological study of the mucous membranes in the esophagus, stomach, duodenum, large and small intestines, as well as a biopsy of the pancreas and liver is carried out. A marker of possible malignancy in the digestive organs is liver cell dysplasia from a biopsy.

Types and forms of duodenal cancer

Primary duodenal cancer is rare and accounts for 0.5% of all cancer cases. In connection with the germination of oncological tumors from neighboring organs, secondary duodenal cancer may develop.

According to the forms (type of growth), cancer occurs:

• exophytic - growing in the intestinal lumen;
• endophytic - growing outside the duodenum.

More often, adenocarcinoma is diagnosed, less often - ring cell cancer, undifferentiated. The share of exocrine cancer affecting the middle third of the duodenum accounts for 65-75% of cases. In this case, the walls of the intestine are affected by the tumor, their lumen narrows, which leads to intestinal obstruction.

With the appearance of a node growing outward, intestinal bleeding is possible, especially with primary cancer. Part of duodenal tumors cause obstructive jaundice, 10-30% spread metastases to the lymph nodes lying nearby.

There are three localizations of tumors in the duodenum:

• the descending section and the peripapillary region, which is referred to as periampullary and peripapillary cancer of the major papilla (in 75% of cases), arising from the epithelium of the pancreas or bile duct;
• the upper horizontal part of the duodenum (suprapapillary cancer, 16%);
• the lower horizontal part of the duodenum (infrapapillary or pre-jejunal cancer, 9%).

Other types of duodenal cancer include:

• lymphosarcoma arising from oncocells of the lymphatic tissue;
• growing from smooth muscles;
• from connective tissue cells;
• malignant neuroma - from the sheath of the nerves.

Stages of duodenal cancer

According to the Clinical classification of tumors (described in the article), duodenal cancer has 4 stages:

1. Stage 1 duodenal cancer is small and clearly separated from other tissues. It is located inside the mucous membrane and in the submucosal layer of the duodenum. Regional metastases and new foci of cancer cells are not observed.
2. Stage 2 duodenal cancer increases in size from 2 to 5 cm, grows into the duodenal muscle layers, but does not violate neighboring organs. Gives single metastases to regional lymph nodes.
3. At stage 3, the tumor acquires a significant size (more than 5 cm), extends beyond the intestinal wall and grows into neighboring organs. May be less than 5 cm, but give multiple regional metastases.
4. Stage 4 duodenal cancer 12 acquires different sizes and character. Has distant metastases.

Stages of cancer development

TNM classification

The severity of the tumor process is assessed according to several criteria (size and spread of the tumor, metastases in the lymph nodes and distant organs). For this, the TNM classification is used (Tumor (tumor) Nodulus (node) Metastasis (metastases (spread) to other organs)).

T is the size and extent of the duodenal tumor:

• T1 - the tumor begins to grow through the inner wall of the duodenum 12;
• T2 - the tumor begins to grow into the muscular layer of the wall of the duodenum 12;
• T3 - the tumor begins to grow through the superficial membrane of the duodenum 12;
• T4 - the tumor has completely grown through the duodenal wall.

N - the presence of cancer cells in the lymph nodes:

• N0 - no cancer cells in the lymph nodes;
• N1 - cancer cells are found in 1-2 lymph nodes near the duodenum 12;
• N3 - cancer cells are found in 3-6 adjacent lymph nodes.

M - spread of cancer to other organs distant from the duodenum:

• M0 - the cancer has not spread to other organs;
• M1 - cancer has spread to distant from 12-p.

Cancer in advanced stages

As you know, duodenal cancer stage has 4 development. At the first three stages, the effectiveness of the treatment is still present and can help the patient, but at the last, 4th stage, it is far from always possible to help, because in most cases not everything depends on the treatment. However, this happens. And it is worth talking about the symptoms of cancer in the later stages because at this moment it can provoke complications and slow down the work of other organs. The disease is manifested by general signs of intoxication.

Possible manifestations such as:

• increase in body temperature;
• dry mucous membranes;
• lack of desire to eat;
• vomiting, diarrhea, constipation, nausea;
• yellowing of the skin;
• body weakness;
• psychological problems.

Even if a person ignores all the symptoms and does not want to see a doctor, it is imperative to pay attention to such signs of the disease:

• vomiting after eating, after which it still seems that the stomach is full;
• blood in the stool; jaundice.

It is worth noting! The symptoms of duodenal cancer in men are the same as in women.

Diagnosis of duodenal cancer

How to identify bowel cancer? Initially, it is necessary to analyze the family history for the presence of cancer and diseases of the digestive tract. Then the patient's life history is examined: diseases and bad habits and nutrition.

To confirm bowel cancer, the diagnosis of the skin, mucous membranes of all organs: the mouth and nose, the eyes is necessary to confirm jaundice and cachexia (exhaustion).

Also, a blood test for intestinal cancer is of great importance in the diagnosis: anemia (anemia) is determined by a general blood test.

As a result of laboratory studies:

• helps to identify special proteins that are secreted in tumors;
• a detailed complete blood count - an elevated level of albumin (protein);
• urinalysis can also detect protein (proteinuria) and erythrocytes - red blood cells (erythrocyturia);
• fecal analysis reveals blood in the stool.

Colonoscopy, as an instrumental method, is carried out with an endoscope. At the same time, the internal condition of the intestine is examined and evaluated.

How to check the intestines for oncology without a colonoscopy:

• irrigoscopy;
• capsule examination;
• CT and MRI, ultrasound;
• sigmoidoscopy;
• esophagogastroduodenoscopy (EGDS).

With barium enema, X-rays and a contrast agent are used, while the intestines are pre-cleaned. The study is carried out double: stomach and duodenum. A video camera is built into the endocapsule to study the structure of the gastrointestinal tract and detect pathology. This type of diagnosis is carried out with abdominal pain, hidden bleeding and suspicion of oncology. The patient swallows the capsule on an empty stomach. After 8 hours, the capsule comes out with feces, and during this time all disorders in the stomach and intestines are recorded.

A sigmoidoscope examines 20-30 cm of the intestine through the anus of the patient, then they take material for. It is prescribed for other neoplasms in the rectum.

Computed tomography is a virtual way of performing colonoscopy without a contract substance and insertion into the devices. The degree of compression of the organs by the tumor is determined. An MRI is a more accurate method than a CT scan.

With endoscopy, the doctor examines the inner surface of the esophagus, stomach, duodenum with an endoscope and takes a fragment of the organ for biopsy. Ultrasound indicates the presence of a tumor and metastases.

Additionally, the chest is examined by X-ray to determine metastases and secondary cancer. Conduct examinations with a gastroenterologist and a therapist.

Methods of treatment of duodenal cancer

Treatment of duodenal cancer is carried out by gastropancreatoduodenal resection (GPDR). At the same time, nearby lymph nodes are removed. For small tumors (less than 1 cm): endocrine cell and non-epithelial elderly patients with aggravated diseases, tumors are excised and part of the duodenum is removed. Surgical intervention in this case will be non-radical.

When determining exocrine duodenal cancer, operations are performed in 60-80%, which depends on the structure of the tumor, stage and spread. Endocrine cell tumors of the duodenum are treated with NIERT - Low Intensity Electro Resonance Therapy. Since after GPDR surgery a relapse can develop, metastases can form in the liver, abdominal cavity, therefore, postoperative rehabilitation is carried out using the NIERT method.

After gastropancreatoduodenal resection, metastases can be removed by cryodestruction, thermal destruction, and chemotherapy is also used for duodenal cancer. With lymphosarcoma of the duodenum and doubts about the effectiveness of the radical operation performed, chemotherapy is prescribed. Combined treatment is used for a poorly differentiated tumor and the infiltrative nature of its growth.

Operational treatment

Surgical treatment can have 3 options for carrying out, while the removal of part of the intestine is necessary in all three cases:

1. The first situation, the most severe, occurs when the tumor extends to the excretory duct and doudenal papilla. In this case, the doctor removes not only part of the 12th colon, but also part of the duct and head of the pancreas
2. If the tumor is small, a circular resection is performed, which means the removal of only the affected part of the organ with possible restoration.
3. The third option is also called circular resection, but they resort to it when the intestine is connected end to end, which is also possible.

Duodenal cancer, how long do patients live?

It is administered as part of therapy to enhance the effect of surgical treatment, improve the condition after chemotherapy and improve the quality of life. Of great importance is the correct prolongation of life during and after treatment.

Life expectancy for duodenal cancer within 5 years is:

• 17-67% - after GPDR;
• 60-80% - after removal of resectable tumors.

The prognosis of survival after the treatment is individual and depends on the histology of the oncological tumor, the stage of the disease, the presence of metastases and concomitant chronic diseases, inflammatory processes in the intestines and stomach, age and general condition of the body.

With late diagnosis, the prognosis of bowel cancer is unfavorable. It worsens even more in the presence of metastases in the lymph nodes, stomach, liver and bile ducts, as well as distant metastases. The condition of oncological complications of the duodenum worsens against the background of germination of metastases in nearby organs, stenosis and bleeding.

Prevention of bowel cancer

In order to prevent duodenal cancer, one should revise the diet, give up alcoholic beverages, smoking, and completely switch to a healthy lifestyle. In the presence of gastric and duodenal ulcers, atrophic gastritis, polyps in the stomach and close relatives who have been treated for oncological diseases, it is necessary to undergo an annual gastroscopy and examination by an oncologist.

Conclusions. Oncological tumors in the duodenum can slowly progress in the male and female body equally, more often after 50 years. It is difficult to distinguish duodenal cancer from neoplasms of the head of the pancreas, major duodenal papilla, bile ducts, and stomach due to similar symptoms and features of the course of the disease.
Cancer develops slowly, so you can not ignore the symptoms of any chronic gastrointestinal disease, as well as with metaplasia and dysplasia, diabetes, stomach ulcers and DPS. With early examination, it is possible to detect cancer, the signs of which can hide behind the symptoms of these diseases. Early treatment improves the prognosis of survival after bowel cancer treatment.

Informative video:

The topic of the article is duodenal cancer and the first symptoms of the disease. This topic will be discussed in detail below. We will learn about symptoms, diagnosis, treatment, as well as prognosis given by specialists. Read all you need to know about it in this article.

What is this about?

Duodenal cancer is a disease that occurs in men and women with equal frequency. It most often affects people over 55 years of age. Young people are also prone to pathologies of the 12th colon, but these cases are rare.

The reasons

To begin with, it is worth noting that the nature and causes of oncology for doctors are still a mystery. This means that doctors make certain assumptions, but it is impossible to say that it is a specific factor that causes oncology. Primary, that is, the main causes are unknown even to science, but you can dwell on the secondary causes of cancer, that is, talk about risk factors. They can contribute to the development of duodenal cancer.

Risk factors

It is believed that cancer can occur for a number of reasons. The following causes can contribute to duodenal cancer:

• tobacco and alcohol abuse, drug addiction;
• pancreatitis, diabetes mellitus or stones in the genitourinary system;
• too frequent consumption of food of animal origin;
• genetics.

Other risk factors are also the ecological situation of the environment, chemical exposure and the effect of carcinogens. The appearance of a tumor can also contribute to the use of animal fats, because as a result, the level of cholecystokinin increases, and this, in turn, can lead to hyperplasia of the upper cover of the digestive tract.

Recently, researchers have discovered the fact that some components of coffee can also contribute to cancer. Therefore, excessive consumption of this drink should be added to the possible reasons.

Pathogenesis

The development of oncology is distinguished due to cancer of the duodenal papilla, as well as cancer of the bile duct. The tumor does not affect the intestine completely, but only a few areas. Most often, these are the upper and lower horizontal parts, and the descending section. The clinical course of the disease largely depends on the location of the cancer.

Place of localization

Cancer of the descending part of the 12th colon is very common, in about 75% of cases. It develops from the epithelium of the common mucosa. Establishing the exact localization is always difficult, especially if the examination is carried out in the later stages. Duodenal cancer, the first symptoms of which may not immediately catch the eye, is therefore dangerous, because the treatment is difficult in itself, but in the last stages a person has little chance.

The upper horizontal part of the intestine is the site of cancer localization only in 12-15% of cases. Tumors in the lower horizontal part are also called infrapapillary cancer. Its frequency is up to 10%.

Symptoms

How does duodenal cancer manifest itself? The first symptoms are very similar to those that people experience with stomach cancer. In order to detect cancer in time, oncologists deduced three groups of possible signs.

The first group falls under the phenomenon of intoxication. It is characterized by abdominal pain, loss of appetite, apathy and weight loss. There is also a complete indifference to the outside world.

The second group concerns the phenomenon of obturation. It all starts when the tumor begins to put pressure on other organs. At this time, bile hypertension begins, the liver increases in size, the feces become colorless. There may be jaundice. Doctors note violations in the work of the cardiovascular system, kidney and liver failure may appear, as well as metabolic processes.

The phenomenon of compression occurs in the last stages of the disease, when a person feels severe pain from the fact that the tumor presses on the nerve endings of the pancreas.

A difficult organ from the point of view of physicians is the duodenum. Where it is located and how it hurts, not all people know. The intestine is located immediately below the stomach on the right side, above the navel. can be different, much depends on the stage of the disease and the localization of the disease of the duodenum. Where it is located and how it hurts, you can ask the doctor if there is a suspicion of oncology.

It is not easy to define the disease on your own. Symptoms of duodenal cancer at an early stage cannot be detected, since the disease is asymptomatic. But after a while, a person begins to think about his health because he begins to suffer from regular pain in the abdomen. How does duodenal cancer manifest itself over time? The main symptoms include severe abdominal pain, rapid weight loss, jaundice, fever, itchy skin, and loss of appetite.

Cancer in advanced stages

Stage 4 duodenal cancer has 4 stages. In the first three stages, treatment can still help the patient, but in the last stage it is not always possible to help, because not everything depends on the treatment. However, there have been such cases.

It is worth talking about the symptoms of cancer in the later stages because at this moment it can provoke complications in the work of other organs. Most often, the disease manifests itself with general signs of intoxication. The following manifestations are also possible:

• temperature;
• dry mucous membranes;
• unwillingness to eat;
• vomiting, diarrhea, constipation, nausea;
• yellowing of the skin;
• general weakness of the body;
• psychological problems.

Even if a person ignores all the symptoms and does not want to see a doctor, it is imperative to pay attention to such signs of the disease:

• vomiting after eating, after which it still seems that the stomach is full;
• blood in the stool;
• jaundice.

It is worth noting that the signs of duodenal cancer in men are the same as in women.

Diagnostics

To cure the disease, it is very important to start treatment on time, and for this it is necessary to detect cancer. To date, the diagnosis is carried out by laboratory and instrumental methods. An analysis of tumor markers for stomach and duodenal cancer will help to identify cancer cells in time. It is worth noting that tumor markers are substances that promote the production of cancer cells. Diagnostics consists of three stages:

1. To begin with, an analysis of pathologies and an anamnesis is carried out. The doctor examines the patient, palpates the abdomen. Human clinical complaints are taken into account, such as vomiting, pain, loss of appetite.
2. At the second stage, a laboratory study of the patient is carried out, consisting of a general blood test, urine and feces tests, a biochemical blood test and a tumor marker.
3. The third stage is instrumental examination.

The last stage is the most important in the diagnosis of duodenal cancer. The first symptoms may be erroneous or indicate another disease, but an instrumental study allows you to make an accurate diagnosis. The doctor conducts esophagogastroduodenoscopy, in which the esophagus, stomach, bile duct and 12-fingered intestine are examined. During the analysis, tissues are taken for biochemical analysis.

After that, the doctor directs the patient to a chest x-ray and a contrast x-ray of the duodenum and stomach. Also, the doctor may prescribe an ultrasound, magnetic resonance and computed tomography. Along with this, the patient is examined by all specialists.

Treatment

Every year, more and more common is duodenal cancer. It is impossible to answer how many people live with such a disease, because everything depends not only on the stage at which treatment began, but also on the general health of the body, its ability to resist the disease.

Usually treatment is carried out according to the classical scheme. First, the tumor is removed surgically. Partial removal of the duodenum may be required. Surgery is recommended for people under 75 years of age, but only on the condition that there were no metastases.

After surgical removal of the tumor, chemotherapy is performed, which is necessary to consolidate the result. It is mandatory, as it guarantees the destruction of pathological cells and their growth.

Radiation therapy is most often performed in the early stages of the disease, when it is possible to cure the patient without surgery.

At the end or at the beginning of treatment, therapy may be required, which is aimed at relieving the patient of symptoms. At first, it is needed to help a person undergo treatment, and at the end it is a final measure.

Surgery

Surgical treatment can have 3 options. Removal of part of the intestine is necessary in all three cases. The first situation, the most severe, occurs when the tumor extends to the excretory duct and doudenal papilla. In this case, the doctor removes not only part of the 12th colon, but also part of the duct and head of the pancreas. If the tumor is small, a circular resection is performed, which means the removal of only the affected part of the organ with possible restoration. The third option is also called circular resection, but they resort to it when the intestine is connected end to end, which is also possible.

Forecast

The doctor can predict the patient's future if he knows when the treatment began. The following factors are very important: a person's age, the presence of metastases and inflammatory processes in the organs of the gastrointestinal tract. The situation worsens if metastases are found in the stomach, lymphatic system and bile ducts. Possible complications can lead to the failure of the genitourinary system. Sometimes there is a stenosis of the 12th colon, regular bleeding. It is worth saying that the overall prognosis for patients is unfavorable, but not hopeless. The problem is that it is very difficult to detect cancer in the early stages, when treatment is almost guaranteed to help.

To protect yourself from this terrible disease and the occurrence of cancer of any other organs, you should give up bad habits and revise your diet. As simple as these tips may seem, they really work. Proper nutrition and quitting smoking and alcohol can protect a person from a number of diseases, and not only cancer.

We learned about what duodenal cancer is, as well as everything about its course and treatment. Unfortunately, no one can be guaranteed to protect themselves from oncology. We have already talked about the importance of a healthy lifestyle, but no less important is an attentive attitude to yourself and the signals of your body. Sometimes it is better to go to the doctor once again and get checked.

Duodenal cancer is a very scary cancer. The first symptoms appear at the time of active development of the disease. This circumstance greatly complicates the treatment of cancer.

The disease is characterized by the fact that a malignant neoplasm appears in the upper part of the small intestine.

It occurs mainly at the age of 55 years, regardless of the gender of the person. In young people, duodenal cancer can also appear. But this happens very rarely.

At the initial stage of the disease, cancers arise from the epithelium and depressions of the mucous membrane, as well as from dense glandular tissues. As the disease progresses, the tumor grows into neighboring organs.

Reasons for development

Like other cancers, duodenal cancer does not have a specific cause. Doctors can name only predisposing factors that contribute to the development of the disease:

• craving for alcohol, leading to alcoholism;
• taking drugs;
• smoking;
• addiction to coffee;
• frequent consumption of fatty or meat dishes.

The following diseases lead to duodenal cancer:

• diabetes;
• urolithiasis disease;
• chronic course of pancreatitis.

Often, cancer patients have close relatives with the same disease. All these factors cannot be an indicator leading to the development of pathology. In medical practice, there were cases when people led a completely healthy lifestyle and at the same time developed cancer. The etiology of this disease is not fully understood.

Disease pathogenesis

Usually the tumor appears in the papillary region. In medicine, it is called peripapillary cancer. Suprapapillary cancers, that is, those that form in the upper small intestine, occur in only 16% of patients. Less often, infrapapillary cancer can be detected when the cancer is located in the lower horizontal region of the duodenum 12.

Oncology of the duodenum, unlike other malignant tumors of the gastrointestinal tract, rarely leads to metastases. This gives certain chances to patients with this diagnosis, since only the organ itself or the lymph nodes adjacent to it are affected.

But not everything is so comforting, recovery is possible only at the initial stage of the disease. In addition, duodenal cancer often appears as a result of gastric or pancreatic cancer, which actively metastasize.

How does the disease manifest itself?

In the early stages of oncology of the small intestine, it is almost impossible to diagnose it. As the tumor grows in one or another part of the organ, the clinical picture is determined.

Duodenal cancer symptoms are as follows:

1. With a tumor in the papillary region for a long time, no signs of the disease are observed. Cancer can only be detected during a routine examination or in the later stages, when the first symptoms appear. This is primarily a difficult penetration of bile into the intestines. In this case, the person will feel pain in the right hypochondrium. In addition, nausea will appear and appetite will decrease. As the disease progresses, yellowing of the skin and mucous membranes appears, at first insignificant, but then it will increase. Due to the fact that the outflow of bile is disturbed, and the organ works with difficulty, the patient develops pancreatitis.
2. If the cancer is located in the upper or lower horizontal duodenum, then the symptoms will be slightly different. In this case, there are signs of intestinal stenosis, namely nausea, bloating, pain in the right side under the ribs, heartburn, belching with acidic contents, a feeling of heaviness in the stomach.

As the tumor grows, intestinal obstruction develops. At this time, education can be groped independently. The patient experiences vomiting with an admixture of bile, and squeezing is felt in the right hypochondrium.

The general clinical manifestation of the disease is the same as in other cancer pathologies. So, the general signs of duodenal cancer are as follows:

• anemia;
• lack of appetite;
• sharp weight loss;
• a state of apathy and constant fatigue;
• decrease in working capacity;
• in the later stages, body temperature rises;
• there is a white coating on the tongue;
• increased sweating.

In the later stages, the patient's stomach visually increases. This is achieved through tumor growth. If the decay of the neoplasm has begun, then the person will have black feces during bowel movements.

According to their structure, tumors can be divided into the following types:

• neural sarcoma;
• reticulosarcoma;
• lymphosarcoma.

There are other varieties, but these 3 diseases are most common.

Diagnostic measures

Most often, a person thinks about going to the doctor when the first symptoms of duodenal cancer appear - this is nausea, pain in the right side, vomiting and intestinal obstruction. The first thing a doctor will refer a patient to is an x-ray.

By scanning the intestines, it will be possible to locate the location of the tumor.

The patient is required to undergo an ultrasound examination of the organ. It determines the superficial change in the intestinal mucosa epithelium. Blood, stool and urine tests are given.

In modern medical centers, computed tomography or MRI methods are used. A biopsy is performed - a piece of the tumor is examined and its structure is determined.

EGDS is a procedure in which a biochemical analysis is taken. As a result, the state of such organs as:

• stomach;
• esophagus;
• 12 duodenal ulcer;
• bile ducts.

Only after the diagnosis is made on the basis of the diagnosis, the treatment of the disease is prescribed.

Methods of treatment of duodenal cancer

Surgical treatment. Depending on the level at which the neoplasm is located, the following surgical interventions are performed:

1. If the formation is small and located in the upper horizontal part of the duodenum, a circular resection of the section affected by cancer cells is performed. After that, intestinal patency is restored by direct gastroduodenal anastomosis. Or the operation ends according to the Billroth 2 method, if there are low organ ulcers.
2. If the cancer is of the infrapapillary type, a circular resection of the lower horizontal region of the duodenum is also used. In this case, the intestine is reunited end to end.
3. If there is peripapillary cancer, then the operation can be extremely difficult. Since the tumor is located in the large duodenal papilla and pancreatic excretory duct, it is necessary to remove the affected intestine, the lower part of the common bile and Wirsung ducts and the head of the pancreas.

In the early stages of the disease, laparoscopic surgery is also performed. The tumor is removed through a small incision using microsurgical instruments and under the supervision of optical instruments. Only tissues that are affected by cancer cells are removed.

After any operation, the passage of rehabilitation is indicated. After that, the doctor prescribes chemotherapy to reduce the risk of possible metastasis. Recently, targeted therapy has begun to appear. It involves blocking the growth of cancer cells with targeted protein molecules.

In addition to the fact that medical measures are being taken, the patient will have to radically change their lifestyle.

First of all, the nutrition of the patient is changing. He will have to consume only plant foods for some time. Even fats and proteins will be of vegetable origin. Dairy products are allowed. But whole milk is banned.

What are the survival predictions?

If cancer is detected at stages 1 and 2, then the survival rate in the next five years is 70%. If the tumor is detected later, then, subject to gastroduodenal resection, the five-year survival rate is only 15-20%.

The following indicators are taken into account:

• type of neoplasm;
• the presence or absence of metastases;
• the presence of concomitant diseases;
• patient's age.

Remember that duodenal cancer is best diagnosed at an early stage, and this is achieved only through preventive examinations by a doctor. Then the treatment will be successful. The later stages of the disease are almost not amenable to therapy. Therefore, be as attentive as possible to your health.

Duodenal cancer is a malignant lesion of the colon. Pathology is most often formed in the descending section (75% of cases), as well as in the upper and lower parts of the duodenum. The disease is rare, affecting patients of both sexes older than 55 years. At a young and young age, it is diagnosed in isolated cases. The primary process needs to be differentiated from tumors of the bile duct and duodenal papilla. More often, secondary duodenal cancer is detected, which is formed as a result of the germination of a malignant neoplasm from the stomach or other organs.

Symptoms and Causes

The early stages of the disease proceed without signs of manifestation of a gastric neoplasm. With the progression of the oncological process, symptoms of duodenal cancer appear:

• dizziness;
• nausea;
• general weakness;
• fast fatiguability;
• loss of appetite;
• fast weight loss;
• dry mucous membranes;
• change in skin color - cyanosis, pallor or yellowness;
• increased sweating;
• pain in the hypochondrium;
• feeling of heaviness in the abdomen;
• increase in body temperature.

Discomfort is aggravated after eating, in stressful situations, when drinking alcohol. To improve well-being, patients often take the “embryo” position to relieve pain.

With duodenal cancer, the following symptoms can also be observed: belching, heartburn, impaired stool and sleep. In the later stages, a neoplasm is palpated in the abdominal cavity, nausea becomes constant, vomiting with blood appears, and “tarry” black stools appear.

A significant role in the formation of duodenal cancer belongs to environmental factors: the environmental situation in the place of residence, working conditions, as well as the influence of ionizing radiation. Other provocateurs are:

• heredity;
• chronic diseases of the gastrointestinal tract;
• diabetes;
• eating habits (excessive consumption of convenience foods, coffee, marinades, canned food, fatty, fried foods);
• drinking alcohol and smoking.

Against the background of weakened immunity, the combination of several risk factors provokes a mutation of duodenal cells.

Classification

Cancer of the stomach and duodenum is characterized by metastasis. In the case of duodenal carcinoma, the lymph nodes in the area of ​​the head of the pancreas are predominantly affected.

According to the type of growth, a duodenal tumor is:

• endophytic - growing beyond the affected area;
• exophytic - growing in the intestinal lumen.

In most cases, adenocarcinoma is diagnosed, less often other types of cancer. The main forms of malignant tumors in duodenal cancer are:

• cancer of the major papilla;
• cancer from epithelial tissue;
• leiomyosarcoma;
• fibrosarcoma;
• neuroma;
• undifferentiated cancer;
• unclassified cancer;
• signet cell carcinoma;
• lymphosarcoma.

Duodenal cancer can be a stage of metastasis in cancer of the stomach, breast, uterus, lungs.

The disease has 4 stages of development, differing in signs, size of the tumor and the extent of metastasis:

• I - the neoplasm is small, clearly defined, located in the submucosal layer. There are no symptoms. No metastasis;
• II - tumor 2-5 cm in diameter, grows into the muscle layer. Metastases appear in the lymph nodes;
• III - a cancerous neoplasm more than 5 cm in volume, extends beyond the duodenum. Multiple metastases appear;
• IV - characterized by the collapse of the tumor, extensive metastasis.

In the initial stages, the cured disease has the best prognosis, but it is rarely diagnosed during this period. Late stages are detected in most patients who seek medical help with disturbing signs.

Diagnosis and treatment

A tumor of the duodenum begins to disturb with symptoms as the disease progresses. Diagnostic measures confirming a malignant pathology consist of laboratory and instrumental methods of examination, as well as a doctor's examination with palpation of the abdominal cavity.

Laboratory studies include analysis for oncomarkers, fecal occult blood, KLA, OAM.

Instrumental methods are of the greatest importance in establishing a diagnosis. The standard is esophagogastroduodenoscopy, during which, using a thin endoscope inserted through the mouth into the stomach, the doctor examines the internal organs of the abdominal cavity and, if necessary, performs a biopsy. Additional diagnostic options are also:

• contrast radiography;
• chest x-ray;
• sigmoidoscopy;
• irrigoscopy;
• Ultrasound of the abdominal organs.

Comprehensive diagnosis and examination of symptoms allows you to clarify the form, nature and stage of changes, plan further effective treatment.

If a malignant tumor is detected, the neoplasm is removed along with a part of the duodenum. Can be done in one of three ways:

• when the malignant process spreads to the major duodenal papilla and the excretory duct of the pancreas, gastropancreatoduodenal resection (GPDR) is performed - the affected intestine, the head of the pancreas, as well as the lower part of the bile and Wirsung ducts are cut out;
• with a small pathology, a circular resection is performed - removal of the damaged area with restoration of the patency of the intestinal section;
• a variant of circular resection is also used, when the intestine is connected end to end.

In the early stages of the malignant process, the removal of atypical cells is performed by laparoscopy.

Chemotherapy and radiotherapy may be given before surgery to reduce the size of the tumor, or after surgery to kill remaining cancer cells in the body.

The most dangerous complications of duodenal cancer are: stenosis, bleeding, tumor perforation. A serious problem is extensive metastasis in the later stages, cachexia.

Treating duodenal cancer with folk remedies helps block symptoms. The protective functions of the immune system are also significantly increased. It is used for a malignant process in the duodenum as an auxiliary method in the treatment.

Survival Predictions and Prevention

If duodenal cancer is diagnosed and treated in the first two stages, then the 5-year survival rate is about 70%. With a later detection of the tumor, the prognosis deteriorates to 15-20%. The histological type of neoplasm, age and general health of the patient are also important.

To reduce the likelihood of malignant changes in the duodenum, it is recommended: diet correction, avoidance of stressful situations, giving up bad habits, timely treatment of gastrointestinal diseases and annual preventive examination by a specialist after 50 years or earlier if there is a hereditary predisposition.

Duodenal cancer is a life-threatening and rare disease. Due to the predominantly late diagnosis, the prognosis is unfavorable. The success of treatment and survival depend on the stage of the disease. Duodenal cancer has nonspecific first symptoms, so the early stages of the disease are most often detected by chance, during examination for other gastrointestinal problems.

Duodenal cancer is cancer that begins in the first part of the small intestine, known as the duodenum.

Treatment of the disease can be carried out in various ways, it is necessary to diagnose oncology at an early stage.

In this article, we will look at the first signs of duodenal cancer. The sooner a person suspects this pathology and the sooner he goes to the doctor, the more chances to get rid of cancer.

Causes and symptoms

This organ is known to be the first part or component of the small intestine.

In the duodenum, food is mixed with bile from the gallbladder, as well as with an enzyme from the pancreas, to effectively digest incoming food.

It is important to note that there are four main stages of cancer in this organ, including:

Stage I At this stage, the malignant tumor is located only in the intestinal mucosa.

Stage II. Cancer cells spread to the muscle layer. There are metastases in regional lymph nodes.

Stage III. At this stage, the cancer has spread to nearby organs. Multiple regional metastases.

Stage IV Distant metastases are observed.

There are certain risk factors associated with the development of this cancer. People with celiac disease or Crohn's disease are at increased risk.

The presence of polyps also increases the risk of cancer in the duodenum. Improper nutrition and high-fat diets are also a risk factor.

Reliable causative factors of stomach cancer are still unclear.

It is only known that certain components of bile and pancreatic juice, such as lithocholic acid and some other secondary bile acids, can be carcinogenic agents.

Usually, familial polyposis, as well as a benign epithelial tumor or some other process, can be the causes of the development of a duodenal tumor, specifically affecting the treatment of the disease.

On the other hand, there are some studies that diverticular disease of the colon, as well as the factor of heredity and genetic predisposition, also contribute to the development of inflammation in the duodenum.

The symptoms present will also affect the treatment and methods that will be used by medical professionals during the treatment of the disease.

The first symptoms of the disease are important to determine the treatment regimen, to be diagnosed not only on the basis of tests and analyses, but also taking into account the physical examination of the patient by a doctor.

Symptoms of the disease can be varied, manifested in the form of:

• pain in the stomach;
• desire to vomit;
• prolonged lack of appetite;
• weight loss.

Some people may feel symptoms and signs such as a hard lump in the abdomen. Duodenal disease interferes with digestion, and heartburn and acid reflux may develop.

There may also be signs and symptoms of bleeding from the gastrointestinal tract, which leads to bloody stools.

Increased fatigue and weakness are also common symptoms of the disease, often manifesting as the disease progresses.

A cancerous tumor can cause an obstruction.

If food cannot reach the lower intestines, it will cause pain, acid reflux, and weight loss because food cannot get to where it needs to be processed and absorbed by the body.

Cancer patients may experience sudden abdominal pain, rapid weight loss, nausea, and a feeling of vomiting.

Most cancers are adenocarcinomas. Other types of tumors are carcinoids and sarcomas.

Although carcinoid and sarcomas can develop in the duodenum, they are more common in other parts of the small intestine.

Because many of the symptoms are similar to other types of gastrointestinal disease, a variety of medical tests may be needed to make a diagnosis.

A physical examination is done to check for lumps in the abdomen. A stool sample may be recommended to check for blood in the stool.

Research on the development of tumors in the duodenum is not enough, since this cancer is very rare, and there are not a large number of patients to conduct their examinations.

As a result, there is little evidence on which to base a physician in deciding the best treatment option for cancer.

There is little conclusive information regarding risk factors and the exact etiology of duodenal cancer. However, they are considered to play an important role.

These include:

1. Diet containing a large amount of fat, heavy meals for the stomach.
2. Exposure to carcinogens of chemical or radiation origin.
3. Chronic smoking.
4. Lynch Syndrome.
5. celiac disease
6. Peutz-Gigers disease.
7. Syndrome Gardner.
8. Crohn's disease.
9. Familial adenomatous polyposis.
10. The disease is similar to juvenile polyposis syndrome.
11. Gastric ulcer.

Diagnostic measures and treatment

Several tests are available to diagnose duodenal cancer. These tests include:

Computed tomography

It is one of the main diagnostic tools for detecting cancer.

This is one of the imaging tests and by using this method the inside of the intestine can be observed and then the area of ​​the small intestine affected by cancer can be identified.

Biopsy

This is another important clinical method for detecting cancer in the duodenum.

A small needle is used to cut small sections of the cancer cell or cells, and these tissues are then examined under a microscope to determine the presence of cancerous tissue.

Endoscopy

This is a modern medical technique for detecting cancer. Endoscopy is an important imaging test.

The camera is inserted into the stomach and duodenum. A special computer is used to view the internal image of the intestine.

MRI

This method is also known as the magnetic resonance imaging method. A magnetic wave and a computer are used to view a detailed picture of the intestines as well as any other internal organ.

Using this technique, you can view the image of the intestine, as well as determine the presence of oncology.

Additional tests that may be recommended include an x-ray of the abdomen.

A procedure can be done using a contrast - barium suspension.

Barium coats the intestines and this makes it possible to view it with x-rays. A liver function test, which measures a substance secreted by the liver, may also be used to make a diagnosis.

Cancer treatment often includes chemotherapy and possibly radiation therapy.

Treatment and its types will depend on the age of the patient, the stage of the cancer, and other health conditions that may be present. Surgery may be an option in some cases.

When the operation actually occurs, a technique known as the Whipple operation may be performed. This is the type of surgery that is sometimes possible for this cancer.

During the procedure, the duodenum, part of the pancreas (its head) and gallbladder are usually removed, and the small intestine is brought to the pylorus of the stomach.

Removing part of the pancreas often requires taking pancreatic enzymes to help with the digestive process. They are available in capsule form.

The patient after the Whipple operation can feel completely normal and lead a normal life without difficulty.

It is important that the procedure be done by a highly experienced surgeon, as specific competence is of great importance.

Some patients need to be fitted with feeding tubes to receive nutrients, or drainage tubes to remove excess processed food that cannot pass the blockage.

Treatment for duodenal cancer varies depending on the stage of the disease and where it is found.

Early-stage cancer is easier to eliminate, but later-stage surgery is the most common choice for treating duodenal cancer.

Radiation therapy and chemotherapy are sometimes used, but these treatment options are usually performed in conjunction with surgery. Early stage duodenal cancer can be cured.

Some other therapy options are also available for stomach cancer, such as herbal treatments and alternative therapies.

There are several main ways to prevent cancer.

They are listed below:

1. It is necessary to quit bad habits (smoking, drinking alcohol).
2. It is recommended to consume enough liquid on a daily basis.
3. It is advisable to eat healthy food and follow a proper diet.
4. It is also very important to avoid excessive consumption of tea and coffee, spicy and heavy foods.
5. The patient should eat more fresh vegetables and fruits.

To check the state of health, in particular the small intestine, timely diagnostics are required to identify any problems with the gastrointestinal tract. In the presence of general discomfort, an accurate diagnosis should be obtained.

If the pain does not go away for a long time, there is a need for a serious diagnosis, which could facilitate the recognition of the cause of the complications.

A thorough examination of the condition of the duodenum should identify the exact causes of pain in order to perform the correct treatment.

The prognosis for the development of cancer in the duodenum, both in men and in women of any age, will be made taking into account the stage of the process.

Once the correct diagnosis is established, treatment can be performed properly.

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